One in four GP appointments avoidable, report finds

A new report is estimating that as many as one in four GP appointments across England could be avoided through a shake-up of operations that would reduce bureaucracy and maximise resources.

The Making Time in General Practice Study, by the NHS Alliance and Primary Care Foundation, concludes that 27% of appointments could be avoided through more coordinated working between GPs and hospitals, wider use of other primary care staff, better use of technology, and wider system changes.

Around 16% of GP appointments were found to be for patient issues that actually could have been better addressed by someone else in the wider primary care team - either within the practice (6.5%), in the pharmacy (5.5%), or via a so-called ‘wellbeing worker’ (4%). Better signposting and new support services could help address this, the report notes, freeing-up up precious time and resources for GPs.

Elsewhere, demand on GPs created by hospitals accounted for 4.5%, or an estimated 15 million appointments. Around 2.5% were related to problems with outpatient booking or a patient failing to attend an appointment, requiring an entirely new GP referral. A further 2% were the result of hospital staff instructing the patient to contact the GP for a prescription or other intervention which was part of their hospital care, again highlighting the potential room for improvement through better communication with hospitals.

The study argues that a reduction in bureaucracy across general practice should be made “a national priority”, through immediate steps such as: enabling patients unable to attend a hospital appointment to re-book within two weeks without going back to the GP; for practices to employ a wider range of staff; streamlining communications between hospitals and doctors; and reducing workload of processing information within practices.

More control to patients

Dr Jonathan Serjeant, GP, co-director and co-founder of Brighton and Hove Integrated Care Service and National lead for NHS Alliance’s Accelerate programme, also argues that using today’s IT patients should be given more control over their own patient records rather than this burden staying with GPs.

“If applied quickly, the recommendations set out in this report, particularly those around extending the GP team to incorporate other health professionals, will help reduce the current levels of bureaucracy GPs face on a daily basis,” he said, noting that “the end result is that GP time is freed up, and people have access to all their information whenever they need it.”

The findings are particularly pertinent given the growing pressures on the sector. GPs and practice teams now make 370 million patient consultations a year - 60 million more than just five years ago - and the number is growing as the population ages alongside a surging number of long-term conditions.

At the same time, workforce levels have remained flat and the cash stream is thinning, with general practice now bagging just 8.33% of the overall NHS budget, and many fear that additional demands placed on the system through seven-day working could bring the sector to its knees.